Reform Psychiatric Security Review Board now

Arizona State Hospital

Christopher Lambeth is accused of the horrific murder of a fellow resident in a group home in Gilbert on April 12. There is no doubt this will spark public debate about the risks associated with group homes in residential areas, solidifying the position for Not-In-My-Backyard, or NIMBY, understandably so. The public deserves an expectation from our elected officials at the state and local levels to ensure the utmost standards of safety in our cities and neighborhoods. People living with disabilities like serious mental illness deserve to be provided for with dignity and in a safe environment. 

Holly Gieszl

Before this preventable tragedy occurred, the Association for the Chronically Mentally Ill was already working on a solution: reform Arizona’s Psychiatric Security Review Board, Christopher Lambeth murdered his own grandparents in 2005. Because Christopher was found guilty except insane, he fortunately was committed to the Arizona State Hospital, not an Arizona prison. As someone who was so gravely ill, Lambeth deserved treatment, not punishment and a life behind bars. But the public and taxpayers also deserve safety and accountability from the state agency, the Psychiatric Security Review Board, charged with deciding when individuals sent to the state hospital for treatment are safe to be released and monitoring individuals released into the community.   

The Psychiatric Security Review Board decided to release Lambeth to a group home in August of 2020, and his treatment then fell to his serious mental illness clinic and treatment team in Tucson. In August of 2020, Lambeth asked the board to let him move to Phoenix. He wanted to live alone, but a “transitional” plan placed him in a group home with only eight hours a day of staff on site. The Psychiatric Security Review Board made this decision without even hearing from a psychiatrist and without having an assessment of Lambeth’s risk of living with such minimal supervision. The entire hearing on Lambeth lasted about 20 minutes.    

Moving to Phoenix meant a change in clinics and treatment team contracted through Phoenix-based Mercy Care. After the change, Lambeth’s treatment team was supposed to provide monthly reports to the Psychiatric Security Review Board. How many reports, if any, were provided on Lambeth and whether they were reviewed are unknown.  But between August and the grisly murder, Lambeth did not re-appear before the board.  

Deborah Geesling
Deborah Geesling

For over two years, and after a state audit two years ago that found problems in the way the board operates, Association for the Chronically Mentally Ill has been seeking to reform the board. All efforts to improve the board’s effectiveness and accountability are met with opposition from the board, especially Dr. James Clark, the board’s chairman.   

Arizona citizens deserve better; taxpayers deserve better; the other residents of group homes and our neighborhoods deserve better.  

Pending before the Legislature are two bills, SB1029 and SB1030, both introduced by Sen. Nancy Barto, R-Phoenix, a tireless advocate for safety and better services for individuals living with serious mental illness. SB1029 requires more information and reports for the board to ensure that it treats patients fairly and protects the public. The board now operates without enough information on patients when it makes decisions. The bill proposes a retired judge be the judge, so the board operates by fair rules. 

Because the Psychiatric Security Review Board opposes any changes and claims that it operates perfectly, SB1030 terminates the board and sends the functions that the board performs to the Superior Court in each county. This saves the state money and will ensure that patients get a fair hearing in front of a judge who follows the law. 

Both bills passed out of the Senate and all House committees. They are currently waiting to go to the House floor for a vote.  

You can help by calling and emailing your Arizona representatives and urge them to support SB1029 and SB1030. This victim’s life mattered. 

Deborah Geesling and Holly Gieszl are founding members of the Association for the Chronically Mentally Ill.  

Tragedy strengthens effort to eliminate board

fine 3d image of dark grunge prison

Sen. Nancy Barto is spearheading an effort to abolish the state board that decides whether those who commit serious crimes but were found guilty except insane are fit to return to the community.  

The effort gained urgency after a man allegedly beat another resident of his Gilbert group home to death last month – 15 years after he killed his own grandparents and less than a year after the Arizona Psychiatric Security Review Board decided after a brief hearing that he needed less supervision. 

Legislative efforts to reform the board fell short last year, but have picked up steam this session. SB1029 looks to reform the board, and SB1030 would sunset it and move the board’s duties back to the courts in 2023. 

Barto, R-Phoenix, said the two bills – which are waiting for a floor vote in the House – are being rolled into one. SB1030 will have the reforms outlined in SB1029 while still dissolving the board in a couple years. 

Barto said she’d been hearing concerns about the board for years. When she attended a board meeting to see for herself how it operated, she described it as “haphazard” and unusual. 

“It’s hard to overestimate how lack of rules, really has potentially and actually harmed the public in this instance; we need to rectify it,” she said. 

Christopher Lambeth, 37, last appeared in front of the board in August 2020. Previously committed to the Arizona State Hospital after being found guilty except insane in his grandparents’ murder, Lambeth had been living in a transitional facility in Tucson. At the August hearing, which lasted 20 minutes, his request to move to the Phoenix area was unanimously approved and he was placed in a home with only eight hours of supervision a day. 

Nancy Barto
Nancy Barto

Advocates say the subsequent tragedy was preventable, but predictable, and that it speaks to a litany of problems with the board and how it’s run. They say the board handles cases inconsistently, provides inadequate time for clients and attorneys to prepare for hearings and has insufficient written guidelines and procedures.  

Holly Gieszl, a founding member of the Association for the Chronically Mentally Ill, said Lambeth’s case was a prime example of the board’s dysfunction. Gieszl often attends board meetings to represent her own clients, and she remembers Lambeth’s August hearing setting off alarm bells at the time.  

“Chris comes in, they don’t have a risk assessment; they don’t hear from a physician or psychologist, and they let him go to an eight-hour house,” Gieszl said. “Seven months later, he murdered someone.” 

Board members are appointed by the governor. The board is headed by a retired psychiatrist and has a psychiatrist, psychologist, parole officer and a public member. The board is responsible for deciding whether those who committed serious crimes but were found guilty except insane are fit to be discharged from the state hospital. It is also tasked with monitoring the progress of those on conditional release from the hospital. The board deals with roughly 100 cases a year. 

Some of the issues flagged by Gieszl and others were also noted in a 2018 auditor general report. The report stated that the board needed to develop rules and policies to guide its work, issue orders and notices as statutorily required and make sure it was getting consistent information on the patients’ mental health before making decisions.  

It also stated that some mental health reports were much more detailed than others, with some offering only “general conclusion statements with little or no support.” 

“The lack of sufficient information jeopardizes the Board’s ability to make timely and consistent decisions regarding GEI (guilty except insane) persons,” the report stated. 

While board chairman Dr. James Clark has said that the board completed the recommendations outlined by the audit, advocates disagree and also want more changes. 

“What the PSRB has not changed at all is the way that it has gone about assessing risk before it releases somebody,” Gieszl said, adding that her organization is backing the legislation to address those inadequacies. 

Among the changes proposed in the legislation are placing a retired judge as the chair of the board, giving a 45-day notice to patients before hearings and having the board explain its decisions on each patient. After the board sunsets in 2023, the cases would be transferred to the Superior Court where the person was sentenced as guilty except insane. 

Barto said that in stakeholder meetings, board members were resistant to any sort of change. 

“I think they just really think that the status quo is working,” Barto said. “When you look at what just happened, unfortunately, we’ve known this is coming, something like the tragedy that happened with Mr. Lambeth and who he killed. It’s unfortunate that we have such a prime example of the board’s inability to make a better determination of this man’s future.” 

Clark declined an interview, instead referring to his presentations to the Senate Judiciary Committee and House Criminal Justice Reform Committee. He declined to comment on whether the board handled Lambeth’s case appropriately. 

“(D)oing away with the PSRB and having Superior Courts assume jurisdiction and monitoring/oversight/supervision of individuals adjudicated Guilty Except Insane, as SB1030 proposes, would be a major policy change, a step backwards and would add an extra burden on the Superior Courts that is unnecessary,” Clark said in his written statement.